2024-03-01 10:20:00
In France, 69% of people aged 16 or over report being in good or very good health. In contrast, 9% describe their condition as bad or very bad. The reasons for consulting a doctor to maintain or improve this well-being can vary depending on many factors – age, sex, geographic region or even the season, since some are more conducive to epidemics.
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If respiratory conditions (colds, bronchitis, etc.) are one of the most common reasons for consultation, musculoskeletal disorders, including back pain and joint problems, are also very widespread… and at all ages. Indeed, although often associated with an adult illness, this pain also widely affects children and adolescents.
“The evil of the century”
The figures make back pain (more specifically low back pain) the “disease of the century” in the 20th century – and still in the 21st century. According to the working group on low back pain of the National Institute for Research and Safety (INRS) for the prevention of work accidents and occupational diseases, according to reports from the High Authority of Health (2019) and the Health insurance (2017), nearly 4 out of 5 people will suffer from lower back pain one day.
READ ALSO Is back pain male or female? “The latter represent the second reason for recourse to the treating physician and the third cause of admission to disability for the general scheme; 20% of work accidents are caused by this type of pain linked to manual handling (50%) and falls (10%); 12 million working days are lost each year in France due to lower back pain. » (INRS 2022 report, “Low back pain. Understanding it, preventing it”.)
An illness that also affects children and adolescents
These values mainly concern employees. The economic implications are therefore colossal, with a direct cost of more than a billion euros per year (coverage of care, daily allowances, after-effects, etc.) and indirect costs up to 10 times higher (administrative management, search for substitutes, additional training, maintenance of contract deadlines, loss of productivity, etc.).
But back pain is not a public health problem reserved for adults: more and more children and adolescents also suffer from it, with 25% of children aged 10 to 15 complaining about it. As part of school medicine, there are regular medical examinations and screenings, particularly during certain key years, such as entry into nursery school, preparatory classes, 6th grade and 2nd grade.
The causes of such a development are multiple, numerous and above all difficult to correct, because they correspond to daily habits already assimilated:
various bad postures, maintained for a long time in places of transport, teaching and entertainment;
fatigue due to lack of sleep (a 6-year-old child needs about 11 hours of rest, a teenager 8-9 hours) and stressful restlessness;
poorly designed school bags or bags that are still too heavy (17% of body weight in middle school);
increase in overweight and obesity;
weak abdominal and lumbar support, due to insufficient or even lack of physical activity.
It is estimated that up to 50% of children and adolescents will experience back pain at some point. The consequences are twofold: on the one hand, they can have a negative impact on their quality of life and their ability to participate in physical and social activities; on the other hand, they increase the risk that they will suffer from it in adulthood.
Importance of prevention
Like adults, children and adolescents know, having heard them many times, the ergonomic recommendations to avoid putting excessive strain on their backs. The website of the Ministry of National Education and Youth also provides instructions to be given regarding the weight of the schoolbag, healthy lifestyle habits, the postures to adopt when working on a table… or on the sofa or his bed at home.
In general, here is advice that is valid in all circumstances:
most often maintain a posture by keeping the back straight and fixed;
avoid twisting when handling loads;
lift objects by bringing your supports as close together as possible in order to minimize the resistance levers, use the leg muscles (strong compared to those of the rest of the body) by bending to better exploit them;
avoid lifting heavy loads alone, by enlisting the help of partners or by using handling equipment to make the work easier;
always distribute the loads to be transported fairly;
respect breaks and become aware of work overload and physical fatigue;
muscle strengthening in order to maintain good physical condition by regularly practicing adequate exercises – particularly for the muscles of the back, abdominals and legs. The more developed our muscles are, the less likely we are to suffer injuries.
However, while the combination of good ergonomic practices, caution and common sense is most often well understood on a theoretical level, their application in everyday life – with its own constraints – is much more hazardous… Maintaining postures, good management of body movements, lifting and carrying loads are rarely respected…
The real problem lies in the articulation of this knowledge of prevention and body safety and their application at every moment.
Public health policy in France addresses different aspects of back pain prevention. However, it is difficult to assess its effectiveness, particularly for a young audience.
This question arises for raising awareness of good postures from a very young age… but also for the effectiveness of medical care, rehabilitation and professional reintegration, physical activity, ergonomics at work, take prevention into account in public policies or even research and innovation.
Actions at school level?
To fight against this scourge, it is important to continue to improve prevention policies and actions. Significant promotional work remains to be carried out via a multidisciplinary approach involving different stakeholders such as health professionals, schools and individuals to encourage healthy behaviors and reduce the risk of back pain.
More specifically, the teaching of physical and sports education (PE) can play an essential role in prevention among children and adolescents. In addition to the direct benefits they will derive in terms of quality of life in the short term, the positive consequences will extend into their adult lives.
READ ALSO Back pain: can we trust MRI results? Prevention, but then the good integration and use of adequate physical practices to protect or relieve your back, does not depend on a few actions or a given period. We must be aware of the long-term importance of all these factors, despite the “rehash” aspect that there can be in their repetition!
But appropriate muscle strengthening or optimization of gestures, postures and movements are not anecdotal: they are major aids for a life without back pain, and sometimes it only takes a little to “help yourself”. Leading as little a sedentary life as possible, diversifying your daily activities, favoring a balanced diet… are all simple but proven actions.
To do this, the child must himself understand the reasons for the recommendations made to him – so that they become a choice, and not an abstract (and painful) constraint… He already knows that remaining sluggish and passive for long periods of time in front of a screen, smoking or having reduced physical activity, a poor diet and little sleep are not “good” for him. We must give him the means to consciously decide to adopt good practices… which will benefit him throughout his life.
Philippe Campillo, Staps lecturer, University of Lille
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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